Individual
KELCI FAGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
345 N RIVERVIEW ST STE 730, WICHITA, KS 67203-4267
(316) 202-2110
Mailing address
1000 N EL PASO DR, DERBY, KS 67037-1808
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
06/16/2022
Last updated
06/16/2022
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